肱骨近端、髋部骨折老年女性骨密度和骨代谢指标对比研究

BMD and bone metabolic makers in older female patients with proximal humeral fracture and hip fracture

目的对髋部、肱骨近端骨折老年女性的骨密度和骨代谢指标进行对比分析,进一步揭示上述骨折部位女性患者骨密度和骨代谢指标特征性变化情况。方法经患者及家属同意,共纳入62例老年髋部骨折女性患者(其中股骨颈骨折39例,股骨粗隆间骨折23例)、肱骨近端骨折21例,收集患者年龄、检测患者骨密度、血清骨转换指标(Ⅰ型胶原氨基端延长肽,P1NP;Ⅰ型胶原C端肽β降解产物,β-CTX)。结果肱骨近端骨折女性患者平均年龄为(66.1±8.0)岁,明显小于股骨颈骨折、粗隆间骨折女性患者(P<0.05);肱骨近端骨折女性髋部(T=-1.19±0.66)、腰椎骨密度(T=-1.67±1.00)明显高于粗隆间骨折女性髋部(T=-2.36±1.17)、腰椎骨密度(T=-2.61±1.42)(P<0.05),同时显著高于股骨颈骨折患者髋部骨密度(T=-2.33±0.99)。股骨颈骨折、股骨粗隆间骨折患者髋部、腰椎骨密度相比差异无统计学意义;三组间血清P1NP比较差异没有统计学意义,粗隆间骨折女性血清β-CTX(732.18±334.37μg/L)要明显高于肱骨近端骨折患者(529.66±292.34μg/L)(P<0.05)。结论相对于髋部骨折患者,肱骨近端骨折老年女性患者年龄较低,骨密度相对较高;骨吸收活跃可能是导致粗隆间骨折女性骨密度下降的原因。

Objective To compare BMD and bone metabolic makers in older female patients with proximal humeral fracture and hip fracture.Methods With the agreement of patients and their relatives,62 female hip fractures patients(39 femoral neck fracture patients,23 intertrochanteric fractures patients)and 21 female proximal humeral fracture patients were enrolled in the study.Data including their age,BMD and bone metabolic markers(P1NP andβ-CTX)were collected.Results The mean age of proximal humeral fracture patients was 66.14±8.00 years,significantly younger than that of hip fracture patients(P<0.05).The T-scores of hip(-1.19±0.66)and lumbar spine BMD(-1.67±1)of proximal humeral fracture patients were significantly higher than those of intertrochanteric fracture patients(hip T-score=-2.36±1.17,lumbar spine T-score=-2.61±1.42)(P<0.05);and the hip BMD of proximal humeral fracture patients was higher than that of femoral neck fracture patients(T-score=-2.33±0.99).There were no significant differences in hip and lumbar BMD between intertrochanteric fracture patients and femoral neck fracture patients.There were no significant differences in serum P1NP among the three groups of patients.The serum level ofβ-CTX(732.18±334.37μg/L)of intertrochanteric fracture patients was significantly higher than that of proximal humeral fracture patients(529.66±292.34μg/L)(P<0.05).Conclusion Compared with hip fracture patients,proximal humeral fractures patients had younger age and higher BMD.More active bone resorption might be the cause of the lower BMD in intertrochanteric fractures patients.